From the Globe and Mail, Holly McKenzie-Sutter

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Oren Adamson received a prescription for pre-exposure prophylaxis treatment in July of last year. Also known as PrEP, the once daily pill is believed to reduce the risk of contracting HIV by more than 90 per cent. Health Canada approved PrEP in the form of the drug Truvada last year, but it has remained too expensive for many patients at $1,000 month. It's considerably cheaper – $70 – in the United States, prompting Mr. Adamson to drive from his home in Vancouver across the border every three months to a rented mailbox to pick up his prescription.

That changed in late December when the B.C. government announced it would become the first province, as of Jan. 1, to fully fund the generic form of the drug to patients at risk of contracting HIV – a policy that has seen 600 patients enroll in the program, but, patients and doctors say, hasn't completely removed the barriers to getting the drug. In Mr. Adamson's case, even with a Vancouver-based physician who was supportive and open to prescribing PrEP, he had to educate his doctor about the funding decision.

"I was a little surprised. It seems like the word isn't really out as much as I thought it was," said Mr. Adamson. "I see it on my Facebook, in my social group it's talked about and it's a thing, but I guess it's not everywhere."

"Sometimes people think, 'Oh, there's a program, so the work is done.' What we're saying is, it's really not. For us the work is just beginning."

The funding program, which is overseen by the Vancouver-based BC Centre for Excellence in HIV/AIDS, or BC-CfE, provides the drug for free to people at high risk of infection. As of Feb.15, there were 601 people enrolled in the program, with 32 requests still being processed. Of those, 60 per cent are completely new to PrEP. So far, 120 physicians in B.C. have prescribed the treatment. Dr. Julio Montaner, director of the BC-CfE, said it was a positive trend that suggests the "dear doctor letters" and educational materials sent to prescribing physicians from the BC-CfE are having an impact.

"I think this is very encouraging," said Dr. Montaner. "The number of physicians prescribing PrEP is quite substantial within six weeks of the program."

But advocates think there's still work to be done breaking down remaining barriers to access – whether those barriers are geographical or stigmatic.

"Now that cost is not a factor, it's actually getting people on the medication that's going to be the next big thing," says Jody Jollimore, executive director of the Community-Based Research Centre for Gay Men's Health. "Sometimes people think, 'Oh, there's a program, so the work is done.' What we're saying is, it's really not. For us the work is just beginning." In order to get on PrEP, a patient first needs a doctor to approve their request and submit a form to the BC-CfE on their behalf; the patient is also sent for blood tesets.

To read the complete article by Holly McKenzie-Sutter, visit the Globe and Mail, here.

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